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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
3023.0: Monday, December 12, 2005 - 9:00 AM

Abstract #109503

Disease Outbreak Detection Using ED Syndromic Surveillance in Los Angeles County

Akbar Sharip, MD , MPH1, Curtis Croker, MPH2, Rita Velikina, MPH3, Patricia Araki, MPH3, Moon Kim, MD , MPH3, Dee Ann Bagwell, MA, MPH3, Raymond Aller, MD, MPH3, and Laurene Mascola, MD, MPH3. (1) Acute Communicable Disease Control Program, Bioterrorism Preparedness and Response Program, Los Angeles County Department of Health Services, 313 North Figueroa, Room 222, Los Angeles, CA 90012, (2) LADHS, ACDC Program, BT Unit, 313 N. Figueroa St #222, Los Angeles, CA 90012, 213-989-7208, ccroker@ladhs.org, (3) 90012

Background The Los Angeles County Syndromic Surveillance System was designed for the early detection of intentional or unintentional disease outbreaks. Several outbreaks and illness clusters were examined to evaluate the system's performance.

Method An active semi-automated, SAS-based surveillance system was established to monitor daily emergency room chief complaints for four syndromes- rash, respiratory, neurological or gastrointestinal. A thirty-day baseline was established for each syndrome and each hospital. A syndrome count that exceeded its baseline was deemed a signal and reviewed by clinical and epidemiological staff. Signal magnitude, geographic clustering of cases, and line listings were reviewed. If there was clustering of complaints indicating potentially unusual medical events hospital staff were contacted and patient charts were reviewed.

Results Between November 2003 and November 2004 there were 84 signals reported by the system. Twenty seven of these signals were gastrointestinal, 16 neurological, 8 rash, and 33 respiratory. Seventy eight signals were internally investigated and closed by epidemiological staff and 6 led to follow-up hospital chart review. The majority of signals were reviewed and closed within 24 hours and the remaining were closed within 72 hours. The system allowed early detection of increases in viral meningitis, influenza, rotavirus, scabies, and gastritis among children. The system also detected increases in respiratory complaints during the LA Marathon.

Conclusion The quick detection and response times to these outbreaks and illness clusters exemplifies the utility of the LA County syndromic surveillance system as a complement to traditional infectious disease surveillance.

Learning Objectives:

Keywords: Epidemiology, Surveillance

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Syndromic Surveillance and Bioterrorism

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA